Provider Demographics
NPI:1386283786
Name:GRIFFIN, ALICIA CATHERINE
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:CATHERINE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-6012
Mailing Address - Country:US
Mailing Address - Phone:845-754-4944
Mailing Address - Fax:
Practice Address - Street 1:6 ADAMS ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6012
Practice Address - Country:US
Practice Address - Phone:845-754-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist